Provider Demographics
NPI:1073660593
Name:WOJCIK, ANTHONY BERNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:BERNARD
Last Name:WOJCIK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8799 ESSEN DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1650
Mailing Address - Country:US
Mailing Address - Phone:586-731-4216
Mailing Address - Fax:
Practice Address - Street 1:52131 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3529
Practice Address - Country:US
Practice Address - Phone:586-739-6363
Practice Address - Fax:586-739-6473
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010172111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice